A Case of Hemolytic Uremic Syndrome Following Mitomycin C Treated with Long Intensive Plasmapheresis

Korean Journal of Nephrology 2010;29(5):662-666.

Dong Ho Shin, M.D., Mi Jung Lee, M.D., Hyun sung Park, M.D., Jwa-kyung Kim, M.D., Jung Tak Park, M.D., Tae Ik Chang, M.D., Tae-Hyun Yoo, M.D., Shin-Wook Kang, M.D. and Kyu Hun Choi, M.D.

Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Korea

증례 : 장기간 집중적인 혈장반출법으로 치유된 mitomycin C에 의한 용혈요독증후군 1예

신동호, 이미정, 박현성, 김좌경, 박정탁, 장태익, 강신욱, 최규헌, 유태현

연세대학교 의과대학 내과학교실, 신장내과

Abstract

HUS (Hemolytic Uremic Syndrome) is characterized by acute renal failure, microangiopathic hemolytic anemia, and thrombocytopenia. In classical HUS, hemorrhagic diarrhea precedes. It is frequently associated with E. Coli O157:H7. Less frequently, HUS may also develop after various treatments such as mitomycin C, cyclosporine, quinine, and ticlopidine. Plasmapheresis is effective in most of classical HUS, which induces a complete remission in most patients with classical HUS. However, this treatment is ineffective in HUS associated with mitomycin C. Although Plasmapheresis is effective on hematologic abnormality in this atypical HUS, chronic renal insufficiency frequently persists as a sequella in HUS associated with mitomycin C. We here report on one patient who developed HUS following mitomycin C therapy due to cervix cancer. The patient was treated with intensive and prolonged plasmapheresis. There was a complete hematologic improvement and steady improvement in renal function.

Key Words: Hemolytic-Uremic syndrome, Mitomycin, Plasmapheresis